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Neonatal screening for congenital hypothyroidism in The Netherlands: Cognitive and motor outcome at 10 years of age

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Author: Kempers, M.J.E. · Sluijs Veer, L. van der · Nijhuis-van der Sanden, R.W.G. · Lanting, C.I. · Kooistra, L. · Wiedijk, B.M. · Last, B.F. · Vijlder, J.J.M. de · Grootenhuis, M.A. · Vulsma, T.
Type:article
Date:2007
Institution: TNO Kwaliteit van Leven
Source:Journal of Clinical Endocrinology and Metabolism, 3, 92, 919-924
Identifier: 239856
doi: doi:10.1210/jc.2006-1538
Keywords: Health · Jeugd en Gezondheid · motor performance · Netherlands · Child · Cohort Studies · Congenital Hypothyroidism · Female · Follow-Up Studies · Humans · Infant, Newborn · Intelligence · Male · Motor Skills · Neonatal Screening · Netherlands · Thyroxine · Time Factors

Abstract

Context: Patients with thyroidal congenital hypothyroidism (CH-T) born in The Netherlands in 1981-1982 showed persistent intellectual and motor deficits during childhood and adulthood, despite initiation of T4 supplementation at a median age of 28 d after birth. Objective: The present study examined whether advancement of treatment initiation to 20 d had resulted in improved cognitive and motor outcome. Design/Setting/Patients: In 82 Dutch CH-T patients, born in 1992 to 1993 and treated at a median age of 20 d (mean, 22 d; range, 2-73 d), cognitive and motor outcome was assessed (mean age, 10.5 yr; range, 9.6-11.4 yr). Severity of CH-T was classified according to pretreatment free T4 concentration. Main Outcome Measure: Cognitive and motor outcome of the 1992-1993 cohort in comparison to the 1981 to 1982 cohort was the main outcome measure. Results: Patients with severe CH-T had lower full-scale (93.7), verbal (94.9), and performance (93.9) IQ scores than the normative population (P < 0.05), whereas IQ scores of patients with moderate and mild CH-T were comparable to those of the normative population. In all three severity subgroups, significant motor problems were observed, most pronounced in the severe CH-T group. No correlations were found between starting day of treatment and IQ or motor outcome. Conclusions: Essentially, findings from the 1992-1993 cohort were similar to those of the 1981-1982 cohort. Apparently, advancing initiation of T4 supplementation from 28 to 20 d after birth did not result in improved cognitive or motor outcome in CH-T patients. Copyright © 2007 by The Endocrine Society.